Autism Awarness Month Special Article

The Autism Spectrum Disorder (ASD) is a condition affecting various aspects of a child's development in various degrees, hence the term "spectrum." 

Therefore, being on the "spectrum" can manifest very diffrently from one person to another.

ASD affects two major areas of development:

1. Social communication (verbal and non verbal, comprehention and expression)
2. Behaviors, interests, and play

It can also affect other aspects of development such as:

• Motor skills development (toe walking, balance issues, coordination, etc.)
• The process of sensory information percieved by the 5 senses (sensory integration, modulation, and regulation)
• Attention and emotionnal regulation
• Sleep (interrupted or unusual sleep patterns)

ASD is often associated with:

• Other genetic or medical conditions such as epilepsy, fragile X syndrome, premature births, anxiety disorders, depression and burn-outs.
• Language delays or abscence of verbal language and learning impairments (dyslexia, dysgraphia, dyscalculia, etc.)
• Other neurodevelopmental disorders such as ADHD, intellectual disability, or high intellectual potential.

ASD is generally characterized by:

1. Absence or insufficient social communication - Social communication includes all forms of communication, whether it is nonverbal (eye contact, gestures, facial expressions, mimicry), or verbal (language) and social interaction (interest in others, sharing, showing empathy - due to difficulties in decoding facial expressions and emotions). Abnormal social communication can be manifested very differently from child to child. For exemple, some children can be good in some social interactions, but demonstrates major difficulties in decoding verbal communication, needing visual support to learn and understand words.

Individuals with ASD generally show those caracteristics:

• Avoid or make no eye contacts during exchanges with others
• Show few (or a limited variation) or almost no facial expressions
• Use little or no gestures to compensate or support verbal language
• The use of communication is mostly for expressing needs rather than to share fealings or interests
• Delayed or atypical language development, and for some, no language development
• Self-talk (self-monologues)
• Seem more interested in objects than in people
• Little or no reaction to their name being called
• Shows no interest in the company of other children
• Prefers playing alone according to their own interests, their own ways. If they are playing with others, they often impose their ideas and ways to others
• Little or no sharing of thoughts or feelings with peers
• Difficulty in decoding facial expressions, intentions, feelings, and also decoding the needs of others (called empathy by some experts, but in fact, it is an inability to "read" other's needs and emotions)

2. Restricted and repetitive behaviors, intense interests, and play: Repetitive behaviors are often observed such as:

• Hand clapping (flapping) or jumping up and down, especially when they are excited, angry or are experiencing an intense emotion
• Rocking or swaying, running or walking back and forth, tapping on an object, hitting themselves, bitting their own hand, repetitive head banging.
• Long atypical visual explorations and visual inspection of objects or object parts from a particular angle (lateral gaze), for example, the child may lye on the floor to better gaze at a toy's wheels, or place the object very close to his face and eyes to observe it in a particular angle
• Arranging or manipulating objects in a repetitive manner, such as aligning, turning, throwing, sorting, organizing, etc.

• Focusing on a particular theme very intensly (dinosaurs, trains, airplanes, letters, numbers, music, logos, dates, arts, animals, etc.)
• Repeating learned sequences (imitating scenes and lines from a movie, from a seened social event, or repeating a pattern of actions in play, for example, putting a plush cat toy in a high spot, bringing the firetruck to save it with a figurine coming up the ladder, putting the plush cat down, then repeating the scene over and over)
• Atypical play (no natural tendancy to pretend play or very little)
• Demonstrating excellent visual-spatial skills (like assembling puzzles, manipulating very small objects) and a remarkable memory
• Having difficulty with unexpected changes in routine or/and with transitioning from one activity to another.

Difficulties in sensory integration, modulation, and regulation can affect the behavior of the individual with ASD and therefore complicate their daily life activities. 

They may be over reatcive or hypersensitive to stimuli (for example, to sounds or sunglare) or under reactive or hyposensitive (for example, to pain, cold or heat). Some can be both, in shifts depending on what is the time of the day, or on other factors such as sleep quality, a life change (moving, new sibeling, sickness, etc.), if visiting a new place, meating new people, etc.

Some children and individuals with ASD may require closer supervision as they can have little or no awareness of dangers. Some have a tendancy to flee when overwelmed and require specialized supervision.

There are 3 levels or degres in autism, based on the assistance required daily tasks:

• The first level is called "high functionning", requiring minimal or no assistance in daily tasks, such as Asperger Syndrom (which is now removed from the DSM diagnosis chart)
• The second level is when the child or individual requires moderate assistance (for example, in establishing a routine before going to school or at work, or to regulate emotions or overloads, to tie shoes, etc.)
• The third level is when the person need significant assistance in daily ativities and with communication, such as children with learning imparments like non verbal children, with sever motor skills imparments, when they present behaviours that can be harmfull for themselve or for others, with tendancies to flee, with an intellectual disability, etc.

The most common warning signs in children are:

Between 6 and 12 months

• Does not smile often, or few facial espressions (for example, does not smile in response to a smile)
• Does not make eye contact or avoids it
• Does not reach out to be picked up
• Appears deaf when calling his or her name

At 12 months

Little or no babbling

At 16 months

Does not point (to show something, to ask for something, to show someone they know)

Does not speak any words (Only sounds)

At 24 months

Does not combine two words in a row (phrase)

At any age

Appears to regress, especially when overwhelmed (can stop speaking, forget words or how to accomplish something, can seam withdrawn from the outside world)

Does not seem interested in social interactions or exchanges (asking, shearing, showing)

Causes

Autism Spectrum Disorder is not litteraly a disease, but rather a condition present from birth, secondary to a complex disorder affecting the brain's development, involving several genetic factors, and possibly environmental factors.

The MMR vaccine does not cause autism. There is no scientific evidence to support this claim. Because signs of autism may appear around the same age that the MMR vaccine is administered, some people believe the vaccine causes the condition.

Initially, the controversy over the MMR vaccine and autism came from a single paper published in 1998 that suggested a link. The report has been found to be fraudulent, and was withdrawn by the journal that published it. Also, many important scientific studies around the world have found no link between the MMR vaccine and autism.

In addition, there is also no evidence to link any other vaccines to autism. The number of children with autism seems to have increased in the recent years. This is mainly explained by including the autisme diagnosis of children presenting milder symptoms who would not have been diagnosed in the past. There is also greater public awareness of autism, and more parents are seeking out help. Moreafter, scientists recently found a gene linked to autism.

Today, autism:

Affects 1 child in 68 children and 1 boy in 42 boys.